netFormulary South East London Joint Medicines Formulary NHS
Guy's and St Thomas' NHS Foundation Trust
Kings College Hospital NHS Foundation Trust
Lewisham and Greenwich NHS Trust
 Formulary Chapter 2: Cardiovascular system - Full Chapter
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02.12  Expand sub section  Lipid-regulating drugs
02.12  Expand sub section  Bile acid sequestrants
02.12  Expand sub section  Ezetimibe
02.12  Expand sub section  Fibrates
02.12  Expand sub section  Statins to top
Atorvastatin tabs

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First Choice
Pravastatin tabs

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Rosuvastatin tabs

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Restricted Drug Restricted Initiation on the recommendation of a Consultant in the Lipid Clinic, Diabetes Unit, HIV Unit or Cardiology only

Restricted to use for:

  • Familial hyperlipidaemia (FH), where other statins have failed to achieve a >50% fall in LDL cholesterol. These patients should be under the care of a lipid clinic

  • Second line for patients requiring ‘high intensity statin’ post ACS, with contraindications or drug interactions that prevent the use of high doses of atorvastatin

  • Third line for patients with CVD or diabetes requiring substantial falls in cholesterol to achieve the minimum QoF audit standard (total cholesterol <5mmol/L and LDL <3mmol/L) with previous failure to tolerate up titrated doses of / or max doses of atorvatatin, and where
    pravastatin is unlikely to deliver the lipid lowering potency required to reach these target levels
    Simvastatin tabs

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    02.12  Expand sub section  Nicotinic acid group
    02.12  Expand sub section  Omega-3 fatty acid compounds
    02.12  Expand sub section  PCSK9 inhibitors
    02.12  Expand sub section  Other lipid modifying agents
    note Notes First Choice Item First Choice item
    Section Title Section Title (top level) Non Formulary Item Non Formulary section
    Section Title Section Title (sub level)
    Cytotoxic Drug
    Cytotoxic Drug
    Restricted Drug
    Restricted Drug
    Controlled Drug
    Unlicensed Drug
    High Cost Medicine
    High Cost Medicine
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    Cancer Drugs Fund
    Cancer Drugs Fund


    Traffic Light Status Information

    Status Description
      Red   Specialist Prescribing only. The responsibility for prescribing, monitoring, dose adjustment and review should remain with the specialist. In very exceptional circumstances a specialist may discuss individual patient need for a RED drug to be prescribed by a GP and the GP should consider informing the Medicines Management team before a decision is made to prescribe for individual patients.   
      Amber 1   Treatment can be initiated in primary care after a recommendation from an appropriate specialist  
      Amber 2   Specialist initiation followed by maintenance prescribing in primary care  
      Amber 3   Specialist initiation with ongoing monitoring required. After dose stabilisation GPs can be requested to take over prescribing responsibilities using the approved APC shared care documentation  
      Green   Specialist and non-specialist initiation  
      Grey   Not recommended for prescribing